Laserfiche WebLink
Pace Analytical' <br />CA Regulated Soil Notification <br />12,01.1b2,0 <br /> <br />USDA APHIS regulates material with organic matter, including soil, from specific <br />counti s that have invasive species, pests, or plant diseases present in the county. In <br />order o process your project, we need to determine if special handling applies to your <br />projec <br />Any s Hs received without this completed form cannot be received or processed until <br />the sit address is confirmed. <br />Recei • t of Soils from California: <br />Are samples soil or other regulated material? <br />Ye E No If no, matrix description: <br />County <br />Al meda 0 Contra Costa 0 Humboldt 0 Lake 0 Los Angeles* 0 Mann <br />M ndocino 0 Monterey 0 Napa 0 Orange* 0 Riverside* 0 San Bernardino** <br />Sa Francisco 0 San Mateo 0 Santa Clara 0 Santa Cruz 0 Solano <br />So oma 0 Trinity <br />en (specify): 511/41/4) loAQatk, <br />(If sot. are from one of the 18 counties specified above, the site address is required.) <br />Site Ad ress: <br />Fire Ant nd •• Fruit Fly quarantines may be partial county quarantines. The site address must be checked against APHIS interactive maps to <br />determin if the site is within the quarantine area. <br />To be completed by Pace National: Client: <br />Lab ID (if applicable): <br />Are Sa pies Regulated? 0 No 0 Yes <br />Regula ed for? 0 Phytophthora Ramorum 0 Fire Ants 0 Fruit Flies* <br />Amoun of soil received: — grams <br />Receiv d on: <br />Will an analysis be done at another lab? 0 Yes 0 No <br />If yes, c mplete the following for each lab that will receive the regulated samples: <br />Receiving lab notified soils are regulated? Shipment <br />eceiving Lab Amount shipped sent with receiving lab's Compliance Agreement? <br /> <br />LI Yes (initial / date) <br />Yes (initial / date) <br /> <br />ID Yes (initial / date) <br />Yes (initial / date) <br />Soils ca ot be transferred to ano her destination without a PPQ 530 form. Contact Jordan Krug at Jordan.d.krug@aphis.usda.gov . <br />Initial / ate after a copy of form has been sent to Anthony Jackson, USDA APHIS PPQ <br />HAQA • C\Public\Controlled Docs\DAV-31 CA Regulated Soil Notification .docx DAV-31 <br />Rev 1 <br />2/12/20